This document provides information on common procedures and post-procedure instructions from Laurel Ob/Gyn. It lists various gynecological procedures performed including colposcopy, LEEP, endometrial biopsy, saline infusion ultrasound, biopsies, and surgeries. It provides post-procedure instructions for each, noting signs to watch out for and when to contact a physician. Instructions include limitations on activities, incision care, follow up appointments, and precautions following various gynecological procedures.
This document discusses the management of vaginal bleeding in early pregnancy. It covers evaluating the woman's condition, diagnosing the potential causes which include threatened abortion, ectopic pregnancy and molar pregnancy. Treatment depends on the diagnosis and may include medication, manual vacuum aspiration, or dilation and curettage. Follow up is important to monitor recovery and provide contraceptive counseling.
The document discusses postnatal assessment procedures for mothers and babies. It outlines the objectives, content, and steps of the assessment. Key points include:
1. Postnatal assessment examines the physical and mental health of the mother and baby's progress in the first 6 weeks after birth. It aims to detect issues, provide health education, and plan family planning.
2. The assessment involves examining the mother's physical health, vaginal bleeding, breastfeeding, perineum, and providing advice. It also involves examining the baby and noting their development.
3. Factors like socioeconomic status, access to healthcare, and health complications can influence a woman's postnatal care and outcomes for her and her baby.
Nausea and vomiting, heartburn, constipation, edema, and urinary frequency are some of the most common minor disorders experienced during pregnancy. Nursing interventions for these conditions include dietary changes like eating small, frequent meals; hydration; exercise; rest; and reassurance that the symptoms are normal and temporary. Proper posture and stress relief techniques can also help alleviate discomfort. Notifying the medical provider is recommended if problems arise like pain, bleeding, or other abnormal symptoms. Overall, minor pregnancy complaints are usually nothing to worry about with simple lifestyle adjustments.
Miscarriage - medical information(causes ,test& diagnosis, management , preve...martinshaji
Miscarriage is the spontaneous loss of a #pregnancy before the 20th week. About 10 to 20 percent of known pregnancies end in miscarriage. But the actual number is probably much higher because many miscarriages occur so early in pregnancy that a woman doesn't even know she's pregnant.
Miscarriage is a somewhat loaded term — possibly suggesting that something was amiss in the carrying of the pregnancy. This is rarely true. Most miscarriages occur because the #fetus isn't developing normally. However, because these abnormalities are rarely understood, it's often difficult to determine what causes them.
Miscarriage is a relatively common #experience — but that doesn't make it any easier. Take a step toward #emotional healing by understanding what can cause a miscarriage, what increases the #risk and what #medical care might be needed.
please comment
thank you
The document discusses minor disorders of pregnancy, including digestive, musculoskeletal, genitourinary, circulatory, and integumentary system changes. Common complaints mentioned are nausea & vomiting, heartburn, constipation, backache, leg cramps, urinary frequency, varicose veins, and skin changes. Potential causes and management strategies are provided for each condition. A more severe form of nausea and vomiting, hyperemesis gravidarum, is also covered.
minor ailments of pregnancy and physical examinationKhushboo Brar
This document provides information on common minor ailments that may occur during pregnancy, including morning sickness, heartburn, constipation, backache, aches and pains, cramps, fainting, varicose veins, swelling, itching, stretch marks, changes in skin color, insomnia, vaginal discharge, and bleeding gums. For each ailment, the document describes causes and provides tips to help alleviate symptoms such as eating small frequent meals, staying hydrated, getting enough rest, and practicing good oral hygiene.
This document provides information about common pregnancy complications, including symptoms and treatment options. It discusses conditions like anemia, depression, gestational diabetes, hepatitis B, high blood pressure during pregnancy, hyperemesis gravidarum, miscarriage, placental problems, preeclampsia, preterm labor, and more. For each complication, it lists associated symptoms and the approaches used to monitor and address the condition. The goal is to help pregnant individuals and their doctors manage health issues that can arise during pregnancy.
Antenatal assessment involves a systematic evaluation of a pregnant woman to monitor her health and the health of the fetus. It includes taking a comprehensive medical history, performing physical examinations, monitoring vital signs, measuring fetal size and heart rate, screening for risk factors, providing education, and discussing birthing options. The timing of antenatal visits includes initial visits monthly until 28 weeks, twice monthly until 36 weeks, and weekly during the last 4 weeks. This systematic supervision aims to determine well-being and chances of survival for both mother and newborn.
This document discusses the management of vaginal bleeding in early pregnancy. It covers evaluating the woman's condition, diagnosing the potential causes which include threatened abortion, ectopic pregnancy and molar pregnancy. Treatment depends on the diagnosis and may include medication, manual vacuum aspiration, or dilation and curettage. Follow up is important to monitor recovery and provide contraceptive counseling.
The document discusses postnatal assessment procedures for mothers and babies. It outlines the objectives, content, and steps of the assessment. Key points include:
1. Postnatal assessment examines the physical and mental health of the mother and baby's progress in the first 6 weeks after birth. It aims to detect issues, provide health education, and plan family planning.
2. The assessment involves examining the mother's physical health, vaginal bleeding, breastfeeding, perineum, and providing advice. It also involves examining the baby and noting their development.
3. Factors like socioeconomic status, access to healthcare, and health complications can influence a woman's postnatal care and outcomes for her and her baby.
Nausea and vomiting, heartburn, constipation, edema, and urinary frequency are some of the most common minor disorders experienced during pregnancy. Nursing interventions for these conditions include dietary changes like eating small, frequent meals; hydration; exercise; rest; and reassurance that the symptoms are normal and temporary. Proper posture and stress relief techniques can also help alleviate discomfort. Notifying the medical provider is recommended if problems arise like pain, bleeding, or other abnormal symptoms. Overall, minor pregnancy complaints are usually nothing to worry about with simple lifestyle adjustments.
Miscarriage - medical information(causes ,test& diagnosis, management , preve...martinshaji
Miscarriage is the spontaneous loss of a #pregnancy before the 20th week. About 10 to 20 percent of known pregnancies end in miscarriage. But the actual number is probably much higher because many miscarriages occur so early in pregnancy that a woman doesn't even know she's pregnant.
Miscarriage is a somewhat loaded term — possibly suggesting that something was amiss in the carrying of the pregnancy. This is rarely true. Most miscarriages occur because the #fetus isn't developing normally. However, because these abnormalities are rarely understood, it's often difficult to determine what causes them.
Miscarriage is a relatively common #experience — but that doesn't make it any easier. Take a step toward #emotional healing by understanding what can cause a miscarriage, what increases the #risk and what #medical care might be needed.
please comment
thank you
The document discusses minor disorders of pregnancy, including digestive, musculoskeletal, genitourinary, circulatory, and integumentary system changes. Common complaints mentioned are nausea & vomiting, heartburn, constipation, backache, leg cramps, urinary frequency, varicose veins, and skin changes. Potential causes and management strategies are provided for each condition. A more severe form of nausea and vomiting, hyperemesis gravidarum, is also covered.
minor ailments of pregnancy and physical examinationKhushboo Brar
This document provides information on common minor ailments that may occur during pregnancy, including morning sickness, heartburn, constipation, backache, aches and pains, cramps, fainting, varicose veins, swelling, itching, stretch marks, changes in skin color, insomnia, vaginal discharge, and bleeding gums. For each ailment, the document describes causes and provides tips to help alleviate symptoms such as eating small frequent meals, staying hydrated, getting enough rest, and practicing good oral hygiene.
This document provides information about common pregnancy complications, including symptoms and treatment options. It discusses conditions like anemia, depression, gestational diabetes, hepatitis B, high blood pressure during pregnancy, hyperemesis gravidarum, miscarriage, placental problems, preeclampsia, preterm labor, and more. For each complication, it lists associated symptoms and the approaches used to monitor and address the condition. The goal is to help pregnant individuals and their doctors manage health issues that can arise during pregnancy.
Antenatal assessment involves a systematic evaluation of a pregnant woman to monitor her health and the health of the fetus. It includes taking a comprehensive medical history, performing physical examinations, monitoring vital signs, measuring fetal size and heart rate, screening for risk factors, providing education, and discussing birthing options. The timing of antenatal visits includes initial visits monthly until 28 weeks, twice monthly until 36 weeks, and weekly during the last 4 weeks. This systematic supervision aims to determine well-being and chances of survival for both mother and newborn.
The document provides information on nursing care of the mother during the postpartum period. Key points include:
- The postpartum period lasts approximately 6 weeks as the body returns to its pre-pregnant state.
- Physiologic changes include uterine involution over 10 days and lochia discharge over 3 weeks. Engorgement may occur between days 3-5.
- Nursing assessments include monitoring vital signs, bleeding, breast engorgement, and bonding with the infant. Interventions focus on preventing infection, reducing pain and fatigue, and promoting breastfeeding and self-care.
It usually takes about 6 weeks to recover from your c-section but this will depend on your individual situation. If you had any problems during or after your c-section, or if you’re looking after other children at home, you may feel you need more time to recover.
1. Hemorrhagic disorders in pregnancy can occur early or late term and include conditions like spontaneous or induced abortion, ectopic pregnancy, molar pregnancy, and placental abnormalities.
2. Spontaneous abortion, also called miscarriage, is the unintentional termination of pregnancy before 20 weeks gestation. Risk factors include chromosomal abnormalities, infections, or lifestyle factors. Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, usually in the fallopian tubes.
3. Molar pregnancy results from abnormal placenta formation causing a cluster of cysts instead of a normal placenta and baby. It carries risks for hemorrhage and later development of gestational troph
This document provides guidance on evaluating and managing common adolescent gynecologic issues. It discusses indications and techniques for pelvic exams and evaluating vaginal discharge. It also reviews causes and treatments for gynecologic pain, abnormal uterine bleeding, amenorrhea, polycystic ovary syndrome, and more. Key topics include ovarian cysts, ectopic pregnancy, endometriosis, and approaches to chronic pelvic pain.
We need to empower the midwife to be decision maker and provied appropriate care fore pregnant women, knowledge is power hope this presentation help first year midwifery student to understand the perpouse of physical assessment
Pregnancy is meant to be a great time for every mother...... but not every mother experiences it that way. This topic will help expectant couples know what to expect and how to handle it. Transiting from womanhood to motherhood shouldn't be so turbulent!. Enjoy it!
This document discusses vaginal bleeding in early pregnancy, which can be caused by implantation bleeding, spontaneous or induced abortion, ectopic pregnancy, molar pregnancy, or infections. It outlines the signs, symptoms, and management of these conditions. Threatened or inevitable abortions are managed with bed rest or uterine evacuation depending on gestational age. Incomplete or septic abortions require uterine evacuation and antibiotics. Ectopic pregnancies require surgery or medication, while molar pregnancies often expel spontaneously but require follow up testing.
This document discusses minor disorders and hyperemesis gravidarum in pregnancy. It begins by outlining minor complaints that are common during pregnancy such as nausea, vomiting, varicose veins, backache, and leg cramps. It then discusses hyperemesis gravidarum, describing it as excessive vomiting that affects the health of the mother. Risk factors, causes, diagnosis, and management of hyperemesis gravidarum are explained. The document concludes by discussing amniotic fluid functions, volume, composition and abnormalities.
Puerperium complications and minor ailments include after pains caused by uterine contractions to expel blood clots, perineal pain from tears or hematomas, breast engorgement from milk accumulation, cracked nipples from improper feeding technique, and mastitis caused by blocked milk ducts or infection. Nursing care focuses on pain management, perineal examination and treatment, frequent breastfeeding or pumping, and antibiotics for infections. Subinvolution of the uterus can occur if the uterus does not fully shrink postpartum and may require exploring the uterus, antibiotics, or pelvic support.
This document provides guidance on assessing the abdomen through inspection, auscultation, percussion, and palpation. It describes the key steps in examining the abdomen, including inspecting the skin, contour, visible organs, and peristalsis. Auscultation involves listening for bowel sounds in all four quadrants. Percussion helps assess gas distribution and identify masses or organ enlargement. Palpation should start with light palpation to identify superficial organs before deeper palpation to check for tenderness.
The document discusses assessment of postnatal women. It begins with definitions related to the postpartum period. It then outlines the focus of physiological and psychosocial assessments during this time, including involution processes, biophysical changes, lactation, the mother's emotional state, interactions with the newborn, and adjustment to the new role. Specific areas to assess during the physical exam are also detailed, such as vital signs, the uterus, breasts, perineum, lochia, and lower extremities. Risk factors, laboratory tests, and the schedule of assessments are provided. Psychosocial factors like attachment, baby blues, and adaptation to parenting are also assessed.
1) The document discusses gravidity, parity, and the signs and symptoms of bleeding in early pregnancy. Gravidity refers to the number of pregnancies and parity refers to the number of viable pregnancies.
2) Examination of a pregnant woman with vaginal bleeding involves general examination, abdominal examination, pelvic examination, speculum examination, and bimanual examination to check for signs of bleeding, masses, cervical changes, and tenderness.
3) Common causes of bleeding in early pregnancy include miscarriage, ectopic pregnancy, molar pregnancy, and other potential issues like placental problems or abnormalities. Management options for miscarriage include surgical, medical, and natural approaches.
This document provides guidance on managing obstetric and gynecological emergencies in the field. It discusses predelivery evaluations, normal delivery procedures, complications like preterm birth and meconium, and abnormal deliveries involving issues like breech presentation or prolapsed cords. It also addresses managing vaginal bleeding, trauma to external genitalia, and sexual assault, emphasizing comprehensive patient assessment, care, and timely transportation to a hospital. Review questions assess knowledge on dealing with predelivery issues, abnormal deliveries, and handling sexual assault incidents.
The document discusses several common minor discomforts experienced during pregnancy, including their causes and nursing interventions. Nausea and vomiting in early pregnancy is caused by increased hormones and usually subsides by 12 weeks. Backaches are caused by relaxed joints and muscles from hormones. Edema in the legs is due to pressure from the uterus restricting blood flow. Nursing advice includes eating small, frequent meals; staying hydrated; getting adequate rest; and wearing support stockings.
Labour is considered prolonged if it lasts more than 12 hours. It can be caused by issues with the passageway (pelvis), passenger (baby), powers (contractions), or psyche (mental state). Prolonged labour risks maternal and fetal complications if neglected. Close monitoring is needed to detect obstruction early. Treatment depends on fetal viability but may include resuscitating the mother, controlling infection, relieving obstruction via c-section, and post-delivery care like antibiotics and bladder drainage. Abnormal uterine contractions can also prolong labour and are treated with oxytocin.
This document discusses minor disorders that may occur in newborns during the postpartum period. It defines minor disorders as non-life threatening conditions that can be effectively managed. The document then describes several common minor disorders such as stuffy nose, sticky eyes, jaundice, skin rashes, vomiting, engorge breast, diarrhea, neonatal constipation, urine retention, vaginal discharge, umbilical granuloma, and regurgitation. For each disorder, the document discusses symptoms, causes, and recommended treatment or management. The conclusion emphasizes that while these minor disorders should not be neglected, they can generally be effectively managed with proper nursing care and education.
This document provides information about adolescence and menstrual health for teenagers. It defines adolescence as the period between ages 10-19 according to the WHO. It describes the physical, psychological, and behavioral changes that occur during adolescence, including sexual maturity and the onset of menstruation. Statistics about adolescent health issues worldwide and in India are presented, such as high rates of pregnancy complications among adolescent girls. The document then discusses the menstrual cycle process and common symptoms. It provides guidance on menstrual hygiene and addresses some common myths and restrictions around menstruation.
This document provides guidance on important aspects of antenatal care. It discusses the aims of antenatal care including monitoring pregnancy progress with minimal interference, providing guidance to expectant mothers, and allowing for early detection and treatment of deviations from normal pregnancy. It outlines recommendations for initial visits, screening tests, vaccinations, and management of common symptoms during pregnancy. The guidance is based on standards from NICE and RCOG and aims to ensure healthy outcomes for both mother and baby.
The document provides information on care after delivery, including:
- The uterus will shrink rapidly in the first few weeks as it contracts back to its normal size, which can cause afterpains that can be relieved with painkillers.
- Bleeding is normal for 2-6 weeks as the uterus shrinks and will change color from bright red to white.
- Exercises like Kegels can help bladder control and decrease risks like prolapse. Bowel function may resume after 2-3 days and eating a healthy diet is important for recovery.
- For c-sections, activities should be gradually increased over weeks and the incision site kept clean as it heals over 6-8 weeks
Este documento proporciona información sobre la presión arterial, incluyendo conceptos básicos, los riesgos de la presión arterial alta, y medidas para controlarla. Explica que la presión arterial se mide en mmHg y se compone de dos cifras, la sistólica y la diastólica. También describe los niveles de presión arterial normal, prehipertensión e hipertensión, y los riesgos que conlleva la presión arterial alta para la salud. Además, ofrece consejos sobre un estilo de vida saludable, medic
Water has played an important role in the architectural heritage of western India from the earliest times. One of the most characteristic features of the early Harappan towns (3000 BC) was the presence of a sophisticated system of drains, wells and tanks. The practice of making wells into an art form was begun by the Hindus but it developed under Muslim rule.
Most of the old temples in south India and palaces in parts of Rajasthan, Bundelkhand, Northern Gujarat and Madhya Pradesh built centuries ago have large tanks in their premises. These tanks are either fed by harvested rain water or by tapping underground springs.
About thousand year’s old and still standing India’s forgotten structures step wells are the fascinating medieval structures. Richard Cox describes their use, “During their heyday, they were a place of gathering, of leisure, of relaxation and of worship for villages of all but the lowest castes. Men gained respite from the heat in the covered pavilions, while the women had a rare chance to chat amongst themselves while drawing water for their families.”
Have been neglected for centuries, efforts are now being made to restore and rejuvenate many of the ruined or drywells.
However author has attempted to focus on scientific and natural facts about the relation between geological setting and imposing environments.
The document provides information on nursing care of the mother during the postpartum period. Key points include:
- The postpartum period lasts approximately 6 weeks as the body returns to its pre-pregnant state.
- Physiologic changes include uterine involution over 10 days and lochia discharge over 3 weeks. Engorgement may occur between days 3-5.
- Nursing assessments include monitoring vital signs, bleeding, breast engorgement, and bonding with the infant. Interventions focus on preventing infection, reducing pain and fatigue, and promoting breastfeeding and self-care.
It usually takes about 6 weeks to recover from your c-section but this will depend on your individual situation. If you had any problems during or after your c-section, or if you’re looking after other children at home, you may feel you need more time to recover.
1. Hemorrhagic disorders in pregnancy can occur early or late term and include conditions like spontaneous or induced abortion, ectopic pregnancy, molar pregnancy, and placental abnormalities.
2. Spontaneous abortion, also called miscarriage, is the unintentional termination of pregnancy before 20 weeks gestation. Risk factors include chromosomal abnormalities, infections, or lifestyle factors. Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, usually in the fallopian tubes.
3. Molar pregnancy results from abnormal placenta formation causing a cluster of cysts instead of a normal placenta and baby. It carries risks for hemorrhage and later development of gestational troph
This document provides guidance on evaluating and managing common adolescent gynecologic issues. It discusses indications and techniques for pelvic exams and evaluating vaginal discharge. It also reviews causes and treatments for gynecologic pain, abnormal uterine bleeding, amenorrhea, polycystic ovary syndrome, and more. Key topics include ovarian cysts, ectopic pregnancy, endometriosis, and approaches to chronic pelvic pain.
We need to empower the midwife to be decision maker and provied appropriate care fore pregnant women, knowledge is power hope this presentation help first year midwifery student to understand the perpouse of physical assessment
Pregnancy is meant to be a great time for every mother...... but not every mother experiences it that way. This topic will help expectant couples know what to expect and how to handle it. Transiting from womanhood to motherhood shouldn't be so turbulent!. Enjoy it!
This document discusses vaginal bleeding in early pregnancy, which can be caused by implantation bleeding, spontaneous or induced abortion, ectopic pregnancy, molar pregnancy, or infections. It outlines the signs, symptoms, and management of these conditions. Threatened or inevitable abortions are managed with bed rest or uterine evacuation depending on gestational age. Incomplete or septic abortions require uterine evacuation and antibiotics. Ectopic pregnancies require surgery or medication, while molar pregnancies often expel spontaneously but require follow up testing.
This document discusses minor disorders and hyperemesis gravidarum in pregnancy. It begins by outlining minor complaints that are common during pregnancy such as nausea, vomiting, varicose veins, backache, and leg cramps. It then discusses hyperemesis gravidarum, describing it as excessive vomiting that affects the health of the mother. Risk factors, causes, diagnosis, and management of hyperemesis gravidarum are explained. The document concludes by discussing amniotic fluid functions, volume, composition and abnormalities.
Puerperium complications and minor ailments include after pains caused by uterine contractions to expel blood clots, perineal pain from tears or hematomas, breast engorgement from milk accumulation, cracked nipples from improper feeding technique, and mastitis caused by blocked milk ducts or infection. Nursing care focuses on pain management, perineal examination and treatment, frequent breastfeeding or pumping, and antibiotics for infections. Subinvolution of the uterus can occur if the uterus does not fully shrink postpartum and may require exploring the uterus, antibiotics, or pelvic support.
This document provides guidance on assessing the abdomen through inspection, auscultation, percussion, and palpation. It describes the key steps in examining the abdomen, including inspecting the skin, contour, visible organs, and peristalsis. Auscultation involves listening for bowel sounds in all four quadrants. Percussion helps assess gas distribution and identify masses or organ enlargement. Palpation should start with light palpation to identify superficial organs before deeper palpation to check for tenderness.
The document discusses assessment of postnatal women. It begins with definitions related to the postpartum period. It then outlines the focus of physiological and psychosocial assessments during this time, including involution processes, biophysical changes, lactation, the mother's emotional state, interactions with the newborn, and adjustment to the new role. Specific areas to assess during the physical exam are also detailed, such as vital signs, the uterus, breasts, perineum, lochia, and lower extremities. Risk factors, laboratory tests, and the schedule of assessments are provided. Psychosocial factors like attachment, baby blues, and adaptation to parenting are also assessed.
1) The document discusses gravidity, parity, and the signs and symptoms of bleeding in early pregnancy. Gravidity refers to the number of pregnancies and parity refers to the number of viable pregnancies.
2) Examination of a pregnant woman with vaginal bleeding involves general examination, abdominal examination, pelvic examination, speculum examination, and bimanual examination to check for signs of bleeding, masses, cervical changes, and tenderness.
3) Common causes of bleeding in early pregnancy include miscarriage, ectopic pregnancy, molar pregnancy, and other potential issues like placental problems or abnormalities. Management options for miscarriage include surgical, medical, and natural approaches.
This document provides guidance on managing obstetric and gynecological emergencies in the field. It discusses predelivery evaluations, normal delivery procedures, complications like preterm birth and meconium, and abnormal deliveries involving issues like breech presentation or prolapsed cords. It also addresses managing vaginal bleeding, trauma to external genitalia, and sexual assault, emphasizing comprehensive patient assessment, care, and timely transportation to a hospital. Review questions assess knowledge on dealing with predelivery issues, abnormal deliveries, and handling sexual assault incidents.
The document discusses several common minor discomforts experienced during pregnancy, including their causes and nursing interventions. Nausea and vomiting in early pregnancy is caused by increased hormones and usually subsides by 12 weeks. Backaches are caused by relaxed joints and muscles from hormones. Edema in the legs is due to pressure from the uterus restricting blood flow. Nursing advice includes eating small, frequent meals; staying hydrated; getting adequate rest; and wearing support stockings.
Labour is considered prolonged if it lasts more than 12 hours. It can be caused by issues with the passageway (pelvis), passenger (baby), powers (contractions), or psyche (mental state). Prolonged labour risks maternal and fetal complications if neglected. Close monitoring is needed to detect obstruction early. Treatment depends on fetal viability but may include resuscitating the mother, controlling infection, relieving obstruction via c-section, and post-delivery care like antibiotics and bladder drainage. Abnormal uterine contractions can also prolong labour and are treated with oxytocin.
This document discusses minor disorders that may occur in newborns during the postpartum period. It defines minor disorders as non-life threatening conditions that can be effectively managed. The document then describes several common minor disorders such as stuffy nose, sticky eyes, jaundice, skin rashes, vomiting, engorge breast, diarrhea, neonatal constipation, urine retention, vaginal discharge, umbilical granuloma, and regurgitation. For each disorder, the document discusses symptoms, causes, and recommended treatment or management. The conclusion emphasizes that while these minor disorders should not be neglected, they can generally be effectively managed with proper nursing care and education.
This document provides information about adolescence and menstrual health for teenagers. It defines adolescence as the period between ages 10-19 according to the WHO. It describes the physical, psychological, and behavioral changes that occur during adolescence, including sexual maturity and the onset of menstruation. Statistics about adolescent health issues worldwide and in India are presented, such as high rates of pregnancy complications among adolescent girls. The document then discusses the menstrual cycle process and common symptoms. It provides guidance on menstrual hygiene and addresses some common myths and restrictions around menstruation.
This document provides guidance on important aspects of antenatal care. It discusses the aims of antenatal care including monitoring pregnancy progress with minimal interference, providing guidance to expectant mothers, and allowing for early detection and treatment of deviations from normal pregnancy. It outlines recommendations for initial visits, screening tests, vaccinations, and management of common symptoms during pregnancy. The guidance is based on standards from NICE and RCOG and aims to ensure healthy outcomes for both mother and baby.
The document provides information on care after delivery, including:
- The uterus will shrink rapidly in the first few weeks as it contracts back to its normal size, which can cause afterpains that can be relieved with painkillers.
- Bleeding is normal for 2-6 weeks as the uterus shrinks and will change color from bright red to white.
- Exercises like Kegels can help bladder control and decrease risks like prolapse. Bowel function may resume after 2-3 days and eating a healthy diet is important for recovery.
- For c-sections, activities should be gradually increased over weeks and the incision site kept clean as it heals over 6-8 weeks
Este documento proporciona información sobre la presión arterial, incluyendo conceptos básicos, los riesgos de la presión arterial alta, y medidas para controlarla. Explica que la presión arterial se mide en mmHg y se compone de dos cifras, la sistólica y la diastólica. También describe los niveles de presión arterial normal, prehipertensión e hipertensión, y los riesgos que conlleva la presión arterial alta para la salud. Además, ofrece consejos sobre un estilo de vida saludable, medic
Water has played an important role in the architectural heritage of western India from the earliest times. One of the most characteristic features of the early Harappan towns (3000 BC) was the presence of a sophisticated system of drains, wells and tanks. The practice of making wells into an art form was begun by the Hindus but it developed under Muslim rule.
Most of the old temples in south India and palaces in parts of Rajasthan, Bundelkhand, Northern Gujarat and Madhya Pradesh built centuries ago have large tanks in their premises. These tanks are either fed by harvested rain water or by tapping underground springs.
About thousand year’s old and still standing India’s forgotten structures step wells are the fascinating medieval structures. Richard Cox describes their use, “During their heyday, they were a place of gathering, of leisure, of relaxation and of worship for villages of all but the lowest castes. Men gained respite from the heat in the covered pavilions, while the women had a rare chance to chat amongst themselves while drawing water for their families.”
Have been neglected for centuries, efforts are now being made to restore and rejuvenate many of the ruined or drywells.
However author has attempted to focus on scientific and natural facts about the relation between geological setting and imposing environments.
Este documento proporciona información sobre la presión arterial, incluyendo conceptos básicos, los riesgos de la presión arterial alta, y medidas para controlarla. Explica que la presión arterial es la fuerza de la sangre en las arterias, y que una medida normal es menor a 120/80 mmHg. También describe factores de riesgo para la presión arterial alta, como la edad, el sobrepeso, el tabaquismo y la diabetes. Además, recomienda medidas de estilo de vida saludables como una dieta baja en sal, ejerc
Año de la misericordia comba gutierreztobias comba
Este documento describe la misericordia como una virtud cristiana que implica compasión por el sufrimiento ajeno y el perdón de ofensas. Explica que el Papa Francisco ha declarado el Año de la Misericordia para recordar que Dios es amor y misericordia, y que nos espera con los brazos abiertos. También resume brevemente la historia de una aparición de la Virgen de la Misericordia en Italia en 1536 y la construcción subsiguiente de una iglesia en su honor.
The document describes Learn Unwired, an online learning platform that aims to make skill development more efficient. It has modules for online learning guides and online tests. The learning guides include videos, presentations, and PDFs on different topics. Students can access these, post doubts, and give feedback. Teachers can upload content, answer student questions, and review artifacts. The online test module allows adding questions to exams by subject and topic. Students can take exams and see results while administrators manage the question bank and student performance reports. The project uses technologies like Visual Studio, SQL Server, and has user interfaces for student, teacher and administrator functions.
Joyce Rowlands is an accomplished public policy and communications professional with extensive experience in the broader public sector, including senior management roles in health care and professional regulation. She has authored numerous reports and publications on public policy issues. Most recently, from 2009 to 2016, she served as the Registrar and CEO of the College of Registered Psychotherapists of Ontario, building the new regulatory body. She holds graduate degrees in journalism and political science, and has worked as a journalist, policy analyst, and consultant on various public sector projects.
The Cubby is a storage unit that can be mounted on walls or fences both indoors and outdoors. It has hooks to store items and can hold up to 8 hooks, with 6 included. Homeowners are increasingly looking for new storage solutions beyond bins and baskets as they want items stored where they use them. The Cubby addresses this need by providing a unique storage solution that combines hooks and containers. It is a suitable storage option for garages, closets, and other areas of the home.
The document summarizes a study that examined the grey matter of multiple sclerosis patients. The study found an absence of functional peroxisomes in the grey matter of multiple sclerosis patients. Peroxisomes help break down toxins and fatty acids in neural cells. The study used staining, gene expression analysis, and fatty acid quantification to show that multiple sclerosis grey matter has significantly fewer peroxisomes and accumulates more fatty acids compared to normal grey matter. As multiple sclerosis progresses, the levels of a peroxisome membrane protein called PMP70 decrease, indicating fewer peroxisomes over time. This absence of peroxisomes may contribute to multiple sclerosis progression by hindering neural cell function.
El documento presenta el perfil epidemiológico del suicidio en Argentina entre 1988 y 2008. Algunos datos clave son: en 2008, el 80% de los suicidios fueron hombres; las tasas más altas se dieron durante la crisis económica de 2000-2003; la región con más suicidios es la Patagonia aunque el NOA ha experimentado un fuerte crecimiento en la última década. El suicidio representó el 16% de todas las muertes por lesiones en 2008.
August Sander (1876-1964) foi um fotógrafo alemão conhecido por seu projeto "Menschen des 20. Jahrhunderts" ("Pessoas do Século XX"), no qual retratou pessoas de diversas origens e ocupações para documentar a diversidade humana. Seu trabalho foi suprimido pelos nazistas, mas posteriormente reconhecido com exposições no MoMA e publicações póstumas de sua obra.
This document provides information about various reproductive system tests and procedures. It discusses alpha-fetoprotein testing during pregnancy to screen for birth defects or other issues. It also describes Pap smear testing to detect cervical cancer, as well as endometrial biopsy and colposcopy to examine the cervix. Further, it summarizes procedures like hysteroscopy, laparoscopy, and semen analysis used to evaluate fertility and reproductive health issues.
Major obstetrical complications of pregnancy include spontaneous abortion (miscarriage), ectopic pregnancy, hydatidiform mole, placental abruption, and placenta previa. Miscarriage is the ending of a pregnancy before 20 weeks and can be caused by chromosomal abnormalities, infection, or uterine defects. Ectopic pregnancies occur when the fertilized egg implants outside the uterus, usually in the fallopian tubes, and require medical or surgical treatment. A hydatidiform mole is an abnormal mass of tissue that develops inside the uterus instead of a baby and requires surgical removal followed by monitoring to prevent cancer. Placental abruption and placenta previa both involve problems with the placenta and can
The document discusses abortion and post-abortion care. It defines abortion as the termination of pregnancy before viability and notes definitions vary by country and gestational age cut-offs. It describes spontaneous versus induced abortion and classifications of incomplete versus complete abortion. Post-abortion care aims to reduce morbidity and mortality through treatment of complications, counseling, contraceptive services, and other health services while partnering with communities.
It is the expulsion or extraction from its mother of an embryo or fetus weighing 500 gm or less when it is not capable of independent survival (WHO).
The 500gm of fetal development is attained approximately at 22 weeks of gestation.
Expelled fetus- Abortus
This document provides an overview of abortion and its complications in developing countries. It discusses the definition, incidence, causes, types, management, and complications of abortion. Some key points include:
- Abortion contributes to 30% of maternal deaths in Tanzania. Complications include hemorrhage, uterine perforation, hematometra, infection, and maternal mortality.
- Types of abortion include threatened, inevitable, incomplete, complete, missed, and septic abortion. Management depends on gestational age and type.
- Causes include infection, psychological stress, nutrition deficiencies, trauma, drugs, uterine abnormalities, and fetal abnormalities.
- Complications in developing countries are made worse by lack of access to health facilities
The document defines abortion and discusses its classification, incidence, etiology, and management. It notes that abortion is the expulsion of an embryo or fetus weighing 500 grams or less before 22 weeks of gestation. Abortions are classified as spontaneous, threatened, inevitable, complete, incomplete, missed, or septic. The incidence of abortion in India is estimated at 10-20% of pregnancies. Complications of abortion include hemorrhage, infection, and future obstetric or gynecological issues. The role of nurses is to assess for complications, provide support and education, and monitor for issues like shock.
Early pregnancy bleeding can occur due to threatened, inevitable, incomplete, complete or missed miscarriage. Causes include maternal factors like infections, fetal factors like chromosomal abnormalities, or cervical/uterine abnormalities. Treatment depends on type and severity of bleeding but may include bed rest, medications, D&C, or misoprostol. Ectopic pregnancy occurs when implantation is outside the uterus, commonly in fallopian tubes. Risk factors include STIs and infertility treatments. Symptoms include abdominal pain and vaginal bleeding. Treatment is usually methotrexate or surgery depending on severity. Gestational trophoblastic disease includes molar pregnancy, invasive mole, and choriocarcinoma which are treated with D&C
The dedicated professionals at College Station Urology provide the best urological care for the detection, treatment and prevention of urological diseases-Premier Texas Urology screening, diagnosis and treatment in one place
This document discusses various types of ectopic pregnancies. It begins by defining an ectopic pregnancy as implantation outside the uterine cavity, most commonly in the fallopian tubes. It then discusses the signs, symptoms, risk factors, diagnosis and treatment of tubal, abdominal, ovarian, angular, cornual and cervical ectopic pregnancies. Medical treatments include methotrexate, while surgical treatments include laparoscopy or laparotomy to remove the ectopic pregnancy. Complications can include rupture and internal bleeding. The document provides detailed information on the locations, causes and management of different ectopic pregnancy types.
The document provides an outline and overview of abortion. It defines abortion and discusses the epidemiology, classification, etiologies, diagnosis, complications and management of abortion. It summarizes the different clinical types of abortion such as threatened, inevitable, incomplete, complete and missed abortion. It also discusses the diagnosis, risk factors, complications and diagnostic workup of abortion. Finally, it discusses abortion laws in Ethiopia.
This document discusses high risk pregnancies and abnormal pregnancies. It covers various causes of bleeding in early pregnancy like miscarriage, ectopic pregnancy, molar pregnancy and their signs and symptoms. It also discusses disorders caused by or associated with pregnancy like preeclampsia. Other high risk conditions discussed include infections, cardiac/renal problems, fibroids and pelvic abnormalities. Types of miscarriages like threatened, inevitable, incomplete and septic abortions are explained along with their management. Recurrent miscarriages and investigations for their causes are also summarized.
Fertilization or conception
Union of a sperm and a mature ovum
Takes place in outer third of the fallopian tube
Zygote
Initial name for fertilized ovum
Embryo
Name of product of conception from second through 8th week of pregnancy
Fetus
Name of the product of conception from 9th week through duration of gestational period
The document presents information on several medical conditions that can occur during pregnancy:
1) Hyperemesis gravidarum is severe nausea and vomiting during pregnancy that prevents adequate food/fluid intake and can cause weight loss and nutritional deficiencies.
2) Ectopic pregnancy is when a fertilized egg implants outside the uterus, usually in the fallopian tubes.
3) Gestational trophoblastic disease involves abnormal cell growth in the uterus during early pregnancy that can cause bleeding and other symptoms.
The placenta provides oxygen and nutrients to the growing baby and removes waste from the baby's blood. Placental abruption occurs when the placenta separates from the uterus before delivery, which can decrease the baby's oxygen and cause heavy bleeding in the mother. Placenta previa is when the placenta blocks the cervix, which can cause severe bleeding during pregnancy and childbirth. Both conditions require close monitoring and may necessitate early delivery to prevent complications for the mother and baby.
This document discusses types of miscarriage and management options. There are five types of miscarriage based on clinical presentation: threatened, inevitable, incomplete, complete, and missed. Management options depending on the situation include expectant management (watchful waiting), medical treatment using prostaglandins or mifepristone, or surgical treatment like dilation and curettage. Risks of surgical treatment include cervical trauma, subsequent cervical incompetence, uterine perforation and intrauterine adhesions.
This presentation is brief regarding ectopic pregnancy( pregnancy results from gestation elsewhere than in Uterus) which is quite abnormal.
Presentation also contains the Risk factors, Symptoms, Diagnosis, Treatment
This document discusses abortion, including its definition, causes, types, diagnosis, and management. It defines abortion as the expulsion of the products of conception from the uterus before 20 weeks of gestation or when the fetus weighs less than 500g. It describes the various causes of abortion including faults in the embryo or maternal environment. It discusses the types of abortion like threatened, incomplete, complete, missed, and recurrent abortion. It covers the diagnosis and management of abortion as well as complications like septic abortion. It also describes methods of induced abortion in the first and second trimester.
This document provides information on medical records, including their components, importance, confidentiality, and proper maintenance. A medical record contains a patient's key clinical data such as name, address, diagnosis, treatment notes, and test results. It is important for monitoring treatment, satisfying legal requirements, and having evidentiary value. Medical records should be maintained accurately and not altered improperly.
This document discusses medical consent and provides examples of consent forms. It outlines key items that should be checked in medical consent disputes, including the type of consent, who provided consent, and whether the consent form was properly filled out and witnessed. The document then provides a model for the contents of a consent form, which should include patient details, diagnosis and treatment plans, risks and benefits, costs, and contingencies. Finally, it provides a sample medical non-surgical consent form addressing treatment plans, costs, responsibilities, and contingencies.
This document contains definitions for over 100 medical terms related to clinical negligence. Some key terms defined include: medical negligence, which refers to a lack of appropriate care by a medical professional that leads to injury or illness; misdiagnosis, which is the incorrect identification of a disease or condition; and negligent treatment, which can cause harm through errors like improper dosing of medication, failure to monitor a patient, or surgical mistakes. The extensive list of terms covers areas like obstetrics, orthopedics, ophthalmology, and other medical specialties.
The document discusses criminal liability for medical negligence cases in India. It outlines several key points:
1) The Indian Penal Code contains numerous provisions related to medical malpractice and negligence that can result in criminal charges or liability. Proving negligence in a medical case places a high burden on the complainant.
2) It is extremely difficult to pursue a criminal medical negligence case due to this high burden of proof and the nature of the doctor-patient relationship being one of trust.
3) It may be easier for a patient to approach a case of medical negligence from a consumer protection perspective rather than pursuing criminal charges. Consumer forums have powers to summon parties and award monetary damages.
This document provides information about East Zone Medico Legal Services Pvt. Ltd., a medico-legal consultancy firm based in India. The company offers services related to clinical risk management, negligence claims management, and defending medical practitioners and establishments against medico-legal suits. It works with lawyers to defend cases in various courts. The document outlines the types of medico-legal issues the company can assist with and the benefits clients would receive, such as representation in legal proceedings up to the Supreme Court.
The document discusses criminal liability for medical negligence cases in India. It notes that the burden of proof lies with the complainant to provide clear evidence of negligence. The standard of proof is extremely high, as the doctor-patient relationship is one of trust. It may be difficult to pursue a criminal case, so it is often better to approach it from the perspective of a consumer case. The key Indian Penal Code sections related to medical negligence and malpractice are also outlined.
This document discusses medical records, including their components, importance, confidentiality, and proper documentation. It notes that a medical record contains a patient's key clinical data and consists of identification information, medical history, examination findings, test results, treatment, and progress. Medical records are important for monitoring treatment, referrals, and satisfying legal and insurance requirements. Clinical information in records is confidential, but identification data can generally be released with a legitimate request. Records must be properly maintained, with accurate documentation of any changes, and retained for appropriate time periods depending on the type of case.
This document outlines the Delhi Fire Service Rules of 2010. Some key points:
- It divides Delhi into fire zones, divisions, and sub-divisions for organizational purposes. Each level is headed by a fire officer.
- It covers establishment and administration aspects like recruitment, pay, transfers.
- It discusses the levy of fire tax and other charges on property owners to fund the fire service.
- It lays out general fire prevention measures like constituting a fire prevention wing, minimum safety standards for buildings and events.
- It provides forms and notices related to certificates, deployment, training, and other activities.
- It addresses response to emergencies, fire reporting, water supply,
This document provides information on medical consent forms, including what should be checked in cases of consent disputes, the model contents of a consent form, and a sample medical (non-surgical) consent form. A consent form should include details of the patient, diagnosis and planned treatment/risks/benefits, consent given by the appropriate party, witnesses, and extended consent for additional procedures if needed. The sample form outlines 17 points addressing the treatment plan, costs, decision-making, involvement of additional specialists, facilities, and contacting the primary doctors.
This document is a consent form for the release of medical records from Pineview Gynecology. It provides the patient's name and contact information and allows them to choose whether their records are released to a physician, the patient themselves, or a third party. The patient selects the format and specific information to be released, such as office notes, lab results, or images. Super-confidential information like HIV/AIDS status requires a separate signature to authorize release. The purpose, timeframe, privacy policies, and signatures are documented before the records will be processed and fees may apply depending on the recipient.
This document provides a consent form template for clinicians to use when obtaining consent from a woman undergoing a caesarean section. It outlines the key risks and benefits to discuss, including both serious and frequent risks to the mother's health. The form should be carefully edited to accurately describe the exact procedure and risks based on the individual woman's situation. Clinicians are advised to separate discussions of serious risks from frequent risks when obtaining consent.
1. This document is a consent form for a Cesarean section procedure, which involves surgically delivering a baby through an incision in the lower abdomen.
2. It explains the risks of the Cesarean section like injury, bleeding, and infection to both the mother and baby. It also lists risks of anesthesia.
3. The patient consents to additional procedures if needed, use of tissue/organs removed, medical research/photos, and receiving blood/blood products if required. Signatures are needed from the patient, doctor, witness, and possibly a legal representative.
Tort law addresses civil wrongs not arising from contracts and provides compensation to deter negligence. Medical negligence cases in India fall under tort law. To prove medical negligence, an aggrieved patient must establish that the doctor owed a duty of care, breached that duty, caused damage to the patient, and that the breach directly caused the damage. The Constitution of India protects life and liberty and allows citizens to seek remedies, including for medical negligence. Various sections of the Indian Penal Code also address medical malpractice by defining concepts like good faith, consent, and negligence. The Indian Medical Council Act and Consumer Protection Act further provide means to discipline doctors and seek damages for medical negligence.
The document provides definitions for various medical and legal terms related to clinical negligence. It defines over 50 terms spanning issues that can arise from errors in areas like obstetrics, surgery, medication administration, misdiagnosis and more. Clinical negligence refers to a lack of appropriate care by a medical professional that causes injury or illness.
Forensic medicine deals with applying medical knowledge to legal problems and aiding the administration of justice. It is used by legal authorities to help solve legal issues involving injuries, deaths, accidents, and other medically-relevant legal matters. The primary tool of forensic medicine is autopsy, which can be used to determine cause of death and provide other evidence for legal cases. Forensic medicine involves collecting and analyzing medical evidence to produce objective information for use in the legal system.
Tort law addresses civil wrongs not arising from contracts and provides compensation to deter future negligence. Medical negligence cases in India fall under tort law. To prove medical negligence, an aggrieved patient must establish that the doctor owed a duty of care, breached that duty, caused damage to the patient, and that the breach directly caused the damage. The Indian Constitution and other laws like the Indian Penal Code and Consumer Protection Act also provide grounds for medical negligence cases and define the standards of care owed by doctors. Generally the burden of proof lies with the plaintiff, but rules like res ipsa loquitur can simplify this burden in some cases. The Indian Medical Council Amendment Ordinance of 2013 aims to reform the composition and
This document provides information about Eastzone Medico Legal Services Pvt. Ltd, a company that offers solutions for challenging legal situations. The company offers key benefits for its services but does not specify what those benefits are. Contact numbers are provided to connect with the company.
The document provides guidelines for medico-legal cases (MLCs) and the use of evidence in sexual assault cases. It lists circumstances that should be classified as MLCs, including injury cases suggesting criminal offense, various types of accidents, homicides, poisonings, and more. It describes the collection and purpose of various types of evidence from sexual assault victims, such as hair, blood, semen and other bodily fluids and materials that can identify victims and assailants or link them to each other and crime scenes.
Tort law addresses civil wrongs not arising from contracts and provides compensation to deter negligence. Medical negligence cases in India fall under tort law. To prove medical negligence, an aggrieved patient must establish that the doctor owed a duty of care, breached that duty, caused damage to the patient, and that the breach directly caused the damage. The Constitution of India protects life and liberty and allows citizens to seek remedies, including for medical negligence. Various sections of the Indian Penal Code also address medical malpractice by defining concepts like good faith, consent, and negligence. The Indian Medical Council Act and Consumer Protection Act further provide means to discipline doctors and seek damages for medical negligence.
This document provides guidelines for breech delivery, intrauterine fetal death, and induction of labor. It discusses recommended procedures for diagnosing and delivering breech presentations, managing intrauterine fetal death, and inducing labor through membrane sweeping and pharmacological methods like vaginal prostaglandins. Factors that make vaginal breech delivery or induction inadvisable are also outlined. Continuous fetal monitoring is recommended during labor induction and procedures to assess progress are described.
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Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Laurel ob oct 2016
1. Laurel Ob/Gyn. Below you will find some of the most common disorders we evaluate and
treatments we perform. If you have a question regarding a subject which is not listed,
Abnormal bleeding and
discharge
Adnexal and ovarian
masses and diseases
Adolescent care
Breast disease
Contraceptive
counseling
Diaphragm fitting
Dysplasia of the cervix
Endometrial ablation
Endometriosis
Hysterectomy
Hysteroscopy
Hormonal management
Implanon insertion and
removal
Infertility
IUD insertion
Laparoscopic Surgery
Minimally invasive
surgery
Menopausal symptoms
Osteoporosis screening
and treatment
Pain with intercourse
Pelvic prolapsed
Perimenopausal
symptoms
Pessary fitting
Sexual dysfunction
Sterilization/tubal
ligations
Well woman care
STD screening
Urinary incontinence
Vulvar, Vaginal, and
Cervical Infections and
Disorders
Vulvar pain
Post Procedure Instructions
Below are some of our post procedural instructions. If you do not see your procedure listed, or if
you have any questions regarding these instructions and /or your symptoms, to reach a physician
or nurse for advice. These instructions are not intended to replace the need for you to receive
medical advice about your condition. As always, if you are having a true medical emergency,
please dial 911 for assistance.
After Colpo
If a biopsy was taken, the results will be available in about two weeks. Make sure to schedule a
follow-up appointment.
Do not douche, use tampons, or have sex for one week.
You may experience some cramping or slight bleeding. You may also notice a black, yellow,
gritty, and/or particulate discharge from the medication used after the procedure.
Please call if:
You develop a temperature greater than 100°F
You experience any heavy bleeding (one pad per hour or more)
You have abdominal pain
You have any questions or concerns
After LEEP
Do not have sexual intercourse or place anything in the vagina for four weeks.
Do not use tampons for four weeks
You may experience some cramping or slight bleeding. You may also notice a black, yellow,
gritty, and/or particulate discharge from the medication used after the procedure. This can also be
watery at times.
Please call if:
2. You develop a temperature greater than 100°F
You experience any heavy bleeding (one pad per hour or more)
You have abdominal pain
You have any questions or concerns
After Endometrial Biopsy
If a biopsy was taken, the results will be available in about two weeks. Make sure to schedule a
follow-up appointment. You may experience some cramping or slight bleeding. You may also
notice a black discharge.
Please call if:
You develop a temperature greater than 100°F
You experience any heavy bleeding (one pad per hour or more)
You have abdominal pain
You have any questions or concerns
After Saline Infusion Ultrasound
Do not douche, use tampons, or have sex for one week.
You may experience some cramping or slight bleeding. You may also notice a watery, blood-
tinged discharge.
Please call if:
You develop a temperature greater than 100°F
You experience any heavy bleeding (one pad per hour or more)
You have abdominal pain
You have any questions or concerns
After Biopsy or Excision at the Vulva, Vagina, Perineum
A shallow bath with Epson salt 2 to 3 times a day may help with the healing process.
Diluting your urine with a water bottle as it passes the urethra may decrease irritation at
the biopsy site.
Please do not wipe the biopsy area. Keep the area clean by using warm soapy water or a
baby/toilet wipe and blot the area only. Wiping me cause more bleeding.
Tucks or witch hazel pads may be used and can be soothing.
Your doctor may have specific instructions depending on the reason for the biopsy, the
location of the biopsy, and the method used to perform the biopsy. You and your doctor
should discuss when and if sutures need to be removed or if a dressing should be
changed.
Please call if:
You develop a temperature greater than 100°F
You experience any heavy bleeding (one pad per hour or more)
3. You have redness, swelling, or increasing pain at the biopsy site
You have any questions or concerns
After Biopsy or Excision of a Lesion on the Skin
Your doctor may have specific instructions depending on the reason for the biopsy, the location
of the biopsy, and the method used to perform the biopsy. You and your doctor should discuss
when and if sutures need to be removed or if a dressing should be changed.
Please do not soak the incision site and keep the area as dry as possible when bathing.
Please call if:
You have redness, swelling, or increasing pain at the biopsy site
You have any questions or concerns
After Surgery (Laparoscopy, Hysteroscopy, Abdominal, or Vaginal Surgery)
After most gynecologic surgery, the following will apply. However, your doctor may have
specific instructions for you. Please feel free to call with any questions.
Activity:
No heavy lifting (nothing greater than 10-15 pounds) for the first 2 weeks.
Do not soak your incision(s); shower for the first 2 weeks.
No driving while requiring pain medications and until you can wear a seatbelt
comfortably and react as needed.
No intercourse or tampons or anything in the vagina for 6 weeks.
You may increase your activity as tolerated and gradually each day. It is okay to climb
stairs; however, you may have to rest.
Incision Care:
No soaking the incisions, as mentioned, for the first 2 weeks. If steri-strips are in place, you will
need to try to keep them there until your follow-up appointment. It is important to clean the
incisions daily with soap water and then plain water. You should pat the incision dry. You should
avoid wiping the incision both when washing and drying as this can disrupt the incision.
Follow-up:
Most follow-up appointments are scheduled 2 weeks from the post operative period. However,
you may need to be seen sooner.
Precautions:
Please call if you experience vaginal bleeding greater than 1 pad/hour, a temperature greater than
100.5°F, nausea, vomiting, chills, increasing abdominal pain, malodorous discharge, pain with
urination, chest pain, shortness of breath, sudden edema or pain at your extremities, back pain,
redness or drainage at your incision site, or onset of any worrisome signs or symptoms.
Hepatic disorders in pregnancy may be
4. Unique to pregnancy
Preexisting
Coincident with pregnancy and possibly exacerbated by pregnancy
Jaundice
Jaundice may result from nonobstetric or obstetric conditions.
Nonobstetric causes include
Acute viral hepatitis (most common)
Drugs
Acute cholecystitis
Biliary obstruction by gallstones
Gallstones appear to be more common during pregnancy, probably because bile lithogenicity is
increased and gallbladder contractility is impaired.
Obstetric causes include
Hyperemesis gravidarum (usually causing mild jaundice)
Septic abortion
Both cause hepatocellular injury and hemolysis.
Acute viral hepatitis
The most common cause of jaundice during pregnancy is acute viral hepatitis. Pregnancy does
not affect the course of most types of viral hepatitis (A, B, C, D); however, hepatitis E may be
more severe during pregnancy.
Acute viral hepatitis may predispose to preterm delivery but does not appear to be teratogenic.
Hepatitis B virus may be transmitted to the neonate immediately after delivery or, less often, to
the fetus transplacentally. Transmission is particularly likely if women are e-antigen–positive
and are chronic carriers of hepatitis B surface antigen (HBsAg) or if they contract hepatitis
during the 3rd trimester. Affected neonates are more likely to develop subclinical hepatic
dysfunction and become carriers than to develop clinical hepatitis. All pregnant women are
tested for HBsAg to determine whether precautions against vertical transmission are needed (for
prenatal prophylaxis with immune globulin and vaccination for neonates exposed to hepatitis B
virus
Chronic hepatitis
5. Chronic hepatitis, especially with cirrhosis, impairs fertility. When pregnancy occurs, risk of
spontaneous abortion and prematurity is increased, but risk of maternal mortality is not.
Despite standard immunoprophylaxis, many neonates of women with a high viral load are
infected with hepatitis B virus. Data suggest that antiviral drugs given during the 3rd trimester
may prevent immunoprophylaxis failure. Fetal exposure should be minimized by using antiviral
drugs only when women have advanced hepatitis or hepatic decompensation is a risk.
Lamivudine, telbivudine, or tenofovir are most commonly used.
Corticosteroids given to treat chronic autoimmune hepatitis before pregnancy can be continued
during pregnancy because fetal risks due to corticosteroids have not been proved to exceed those
due to maternal chronic hepatitis. Azathioprine and other immunosuppressants, despite fetal
risks, are sometimes indicated for severe disease.
Intrahepatic cholestasis (pruritus) of pregnancy
This relatively common disorder apparently results from idiosyncratic exaggeration of normal
bile stasis due to hormonal changes. Incidence varies based on ethnicity and is highest in Bolivia
and Chile.
Consequences include increased risk of fetal prematurity, stillbirth, and respiratory distress
syndrome.
Intense pruritus, the earliest symptom, develops during the 2nd or 3rd trimester; dark urine and
jaundice sometimes follow. Acute pain and systemic symptoms are absent. The disorder usually
resolves after delivery but tends to recur with each pregnancy or with use of oral contraceptives.
The disorder is suspected based on symptoms. The most sensitive and specific laboratory finding
is a fasting total serum bile acid level of > 10 mmol/L. This finding may be the only biochemical
abnormality present. Fetal demise is more likely when the fasting total bile acid level is > 40
mmol/L.
Ursodeoxycholic acid (UDCA) 5 mg/kg po bid or tid (or up to 7.5 mg/kg bid) is the drug of
choice. It helps lessen the severity of symptoms and normalize biochemical markers of liver
function; however, it does not decrease the incidence of fetal complications.
Fatty liver of pregnancy
This rare, poorly understood disorder occurs near term, sometimes with preeclampsia. Patients
may have an inherited defect in mitochondrial fatty acid β-oxidation (which provides energy for
skeletal and cardiac muscle); risk of fatty liver of pregnancy is 20 times higher in women with a
mutation affecting long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD), particularly the
G1528C mutation on one or both alleles (autosomally inherited).
6. Symptoms include acute nausea and vomiting, abdominal discomfort, and jaundice, followed in
severe cases by rapidly progressive hepatocellular failure. Maternal and fetal mortality rates are
high in severe cases.
A seemingly identical disorder may develop at any stage of pregnancy if high doses of
tetracyclines are given IV.
Clinical and laboratory findings resemble those of fulminant viral hepatitis except that
aminotransferase levels may be < 500 units/L and hyperuricemia may be present.
Diagnosis is based on clinical criteria, liver function tests, hepatitis serologic tests, and liver
biopsy. Biopsy shows diffuse small droplets of fat in hepatocytes, usually with minimal apparent
necrosis, but in some cases, findings are indistinguishable from viral hepatitis.
Affected women and their infants should be tested for known genetic variants of LCHAD.
Depending on gestational age, prompt delivery or termination of pregnancy is usually advised,
although whether either alters maternal outcome is unclear. Survivors recover completely and
have no recurrences.
Preeclampsia
Severe preeclampsia can cause liver problems with hepatic fibrin deposition, necrosis, and
hemorrhage that can result in abdominal pain, nausea, vomiting, and mild jaundice.
Subcapsular hematoma with intra-abdominal hemorrhage occasionally occurs, most often in
women with preeclampsia that progresses to the HELLP syndrome (hemolysis, elevated liver
enzymes, and low platelet count). Rarely, the hematoma causes the liver to rupture
spontaneously; rupture is life threatening, and pathogenesis is unknown.
Chronic hepatic disorders
Pregnancy may temporarily worsen cholestasis in primary biliary cirrhosis and other chronic
cholestatic disorders, and the increased plasma volume during the 3rd trimester slightly increases
risk of variceal hemorrhage in women with cirrhosis. However, pregnancy usually does not harm
women with a chronic hepatic disorder.
Symptoms of thrombophlebitis or their absence does not accurately predict the diagnosis, disease
severity, or risk of embolization. Thromboembolic disorders can occur without symptoms, with
only minimal symptoms, or with significant symptoms. Also, calf edema, cramping, and
tenderness, which may occur normally during pregnancy, may simulate Homans sign.
Diagnosis
Doppler ultrasonography or sometimes CT with contrast for DVT
7. Helical CT for PE
Diagnosis of DVT is usually by Doppler ultrasonography. In the postpartum period, if Doppler
ultrasonography and plethysmography are normal but iliac, ovarian, or other pelvic venous
thrombosis is suspected, CT with contrast is used.
Diagnosis of PE is increasingly being made by helical CT rather than ventilation-perfusion
scanning because CT involves less radiation and is equally sensitive. If the diagnosis of PE is
uncertain, pulmonary angiography is required.
Treatment
Similar to that in nonpregnant patients, except for avoidance of warfarin
For women with increased risk, prophylactic low molecular weight heparin throughout
pregnancy and for 6 wk postpartum
If DVT or PE is detected during pregnancy, the anticoagulant of choice is a low molecular
weight heparin (LMWH). LMWH, because of its molecular size, does not cross the placenta. It
does not cause maternal osteoporosis and may be less likely to cause thrombocytopenia, which
can result from prolonged (≥ 6 mo) use of unfractionated heparin. Warfarin crosses the placenta
and may cause fetal abnormalities or death (Indications for thrombolysis during pregnancy are
the same as for patients who are not pregnant.
If PE recurs despite effective anticoagulation, surgery, usually placement of an inferior vena
cava filter just distal to the renal vessels, is indicated.
If women developed DVT or PE during a previous pregnancy or have an underlying
thrombophilic disorder, they are treated with prophylactic LMWH (eg, enoxaparin 40 mg sc
once/day) beginning when pregnancy is first diagnosed and continuing until 6 wk postpartum.